Chapter 4: Fluid and Electrolyte Imbalances

The nurse is caring for a client in the intensive care unit (ICU) following a near-drowning event in saltwater. The client is restless, lethargic, and demonstrating tremors. Additional assessment findings include swollen and dry tongue, flushed skin, and peripheral edema. The nurse anticipates that the client's serum sodium value would be a. 155 mEq/L b. 145 mEq/L c. 135 mEq/L d. 125 mEq/L

a. 155 mEq/L

Mrs. Kruger is a 53-year-old woman who has been admitted to the surgical unit following urethral sling surgery that was performed to treat her recurrent stress incontinence. The nurse notes that Mrs. Kruger was treated for breast cancer 3 years earlier and had a left unilateral mastectomy and axillary node biopsy performed. How will Mrs. Kruger's medical history affect the nurse's care during this admission? a. The nurse should use Mrs. Kruger's right arm for IV access and BP analysis b. The nurse should monitor Mrs. Kruger closely for signs and symptoms of hypercalcemia due to her history of cancer c. Venous access should be assessed using a central vein rather than a peripheral vein d. Mrs. Kruger should be placed on a strict I&O monitoring

a. The nurse should use Mrs. Kruger's right arm for IV access and BP analysis

Which is a correct route of administration for potassium? a. Intramuscular b. Subcutaneous c. Oral d. IV push

c. Oral

A client with pancreatic cancer has the following blood chemistry profile: Glucose, fasting: 204 mg/dl; blood urea nitrogen (BUN): 12 mg/dl; Creatinine: 0.9 mg/dl; Sodium: 136 mEq/L; Potassium: 2.2 mEq/L; Chloride: 99 mEq/L; CO2: 33 mEq/L. Which result should the nurse identify as critical and report immediately? a. Sodium b. Chloride c. CO2 d. Potassium

d. Potassium

A client has been admitted to the hospital unit with signs and symptoms of hypovolemia; however, the client has not lost weight. The client exhibits a localized enlargement of her abdomen. What condition could the client be presenting? a. Hypovolemia b. Pitting edema c. Anasarca d. Third spacing

d. Third Spacing

A nurse evaluates a client's laboratory results. What is a factor that may be affecting an increase in serum osmolality? a. Free water loss b. Hyponatremia c. Overhydration d. Diuretic use

a. Free water loss

The nurse is reviewing client lab work for a critical lab value. Which value is called to the physician for additional orders? a. Potassium 5.8 b. Sodium 138 c. Magnesium 2 d. Calcium 10

a. Potassium 5.8

The nurse is caring for a client with a serum sodium concentration of 113 mEq/L (113 mmol/L). The nurse should monitor the client for the development of which condition? a. Hallucinations b. Nausea c. Headache d. Confusion

d. Confusion

A nurse assesses a patient's IV lines on an hourly basis. When checking the IVs this hour, the nurse finds localized pain, redness, warmth, and swelling around the insertion site of a 25-year-old female patient. What is the nurse's first priority? a. Elevate the extremity b. Apply a cold compress c. Apply a warm compress d. Discontinue the IV infusion e. Restart the line in the opposite extremity

d. Discontinue the IV solution Rationale: The patient is showing signs of phlebitis

The nurse is instructing a client with recurrent hyperkalemia about following a potassium-restricted diet. Which statement by the client indicates the need for additional instruction? a. "Bananas have a lot of potassium in them: I will stop buying them" b. "I'll drink cranberry juice instead of coffee" c. "I need to see whether my cola beverage has sodium in it" d. "I will not salt my food, instead I will use a salt substitute"

d. I will not salt my food, instead I will use a salt substitute